excellent feedback from geriatric practitioners yesterday

Yesterday I spoke for the first time to an audience of medical practitioners at Weill Cornell Medical College/NY-Presbyterian Hospital Dept. of Geriatrics. It was in a beautiful conference room in the Gothic hulk of a building next to the East River where my daughter was born 28 years ago next week. I opened with an anecdote from a friend who brought his 83-year-old mother in to the family doctor for a check-up—she was in a wheelchair after a stroke—and when they came into his office the doctor said, “Are you still around?”

Geriatric practitioners know that the medical profession is ageist. What some don’t know, it turns out, is that people are happiest at the beginnings and ends of their lives. Focused on people at one end of the disability spectrum, an occupational hazard is losing sight of the fact that the vast majority of older Americans enjoy being out and about. They know, of course, people the same age look and act very differently. “Look at functionality rather than chronology,” is how one practitioner put it, and another bumped by a decade up the phrase I’ve been using: “If you’ve seen one 90-year-old, you seen one 90-year-old.” And they’re well aware of how ageism impoverishes their patients’ lives. A few were pretty chilly to start with, but by the time we had to turn over the conference room, they were opening up with anecdotes like these:

“I see that people in wheelchairs are invisible. It’s easy to see the whole package as impaired. Aides will jump in and answer for the patient as if she can’t speak for herself. You can have a brain and still not be able to walk.”

“You’d never hear a racist or sexist joke on NPR, but on ‘Wait, Wait, Don’t Tell Me’ they make cracks about old age all the time.”

“Western culture never accepts the idea that things come in a cycle – progression, decline, rebirth. Things always have to increase and improve, go up and up.” (from a young man whose accent I’m guessing was Chinese)

“Names are tricky. The hospital was setting up a psychiatric ward in Westchester and they didn’t want to label it ‘geriatric’ so they called it the Unit for Mature Adults. A kid asked, ‘Mommy where do the immature adults go?’”

“I have a friend with advanced Alzheimer’s, and I was surprised when she didn’t want to go out until her lipstick was on and her hair was combed. I had jumped to the conclusion that dementia meant she no longer cared about her appearance.”

•“I got up to give a woman my seat on the bus and she said, ‘Absolutely not! I want the 13 year old boy behind you to give me his seat.’ And she stood there and waited for his mother to get the kid to stand up.”

That reminded a woman doing her geriatrics residency of a 78 year old patient with MS. “She’s has real difficulty walking, keeps falling even in her own home, but she’s furious when people offer her a seat. She thinks people are judging her by her face.” I asked the doctor whether she wished the woman would accept the offer. “Yes! And I see the same thing with people who won’t use a walker.”

And my favorite: “I have a 105-year-old aunt who told her doctor she was 88. When I asked why, she said, “It’s none of his business.”

I’ll integrate what I learned into my next talk on March 18th, also for an audience of professionals but open to the public. And I’ll use this blurb, from the woman who invited me to speak yesterday, to promote it:

“All practitioners working with older adults need to be informed about the pernicious influences of ageism. Nobody does this better than Ashton Applewhite. Her thinking is deep and her passion infectious. She received rave reviews—‘uplifting,’ ‘inspiring,’ and ‘thought-provoking’—from the physicians, nurses and social workers at the presentation I attended. And her cogent message is spot on: we urgently need to have a national conversation about ageism to raise awareness about it and to stop it.” – Risa Breckman, LCSW, Executive Director, NYC Elder Abuse Center

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Most of the practitioners in the room work with older adults ranging in age and functionality. Indeed, a number of the practitioners in the room – because of their concern about the skewed view of aging that comes from only working with frail elders – have been pioneers in developing programs that expose practitioners to older adults in the community to counter this limited perspective of aging. In fact, one of the physicians in the room developed such a program in the early/mid 80s when he worked with Dr. Bob Butler at Mt. Sinai in the Dept. of Medicine there.

When I lived in New York till recently, the subway behavior of mothers of boys drove me nuts. Loved reply to the person who wanted to give his seat to older woman, ” ‘Absolutely not! I want the 13 year old boy behind you to give me his seat.’ And she stood there and waited for his mother to get the kid to stand up.” How I miss the truthiness of the City. Out here in Portlandia, everyone is so-o-o polite and it’s a challenge to be a stand-up old lady.